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Essentials of Diagnosis
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Intrauterine pregnancy < 20 weeks
Low or falling levels of human chorionic gonadotropin (hCG)
Bleeding or midline cramping pain, or both
Open cervical os
Complete or partial expulsion of products of conception
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General Considerations
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Defined as termination of gestation prior to the 20th week of pregnancy
75% of cases occur before the 16th week, with 75% of these before the 8th week
Almost 20% of clinically recognized pregnancies result in a spontaneous loss
More than 60% of cases result from chromosomal defects
About 15% of cases are associated with
There is no evidence that psychic stimuli such as severe fright, grief, anger, or anxiety can induce spontaneous pregnancy loss
There is no evidence that electromagnetic fields are associated with an increased risk of spontaneous pregnancy loss
It is important to distinguish women with incompetent cervix (cervical insufficiency) from those with early pregnancy loss typically occurring in the first trimester; factors that predispose to incompetent cervix, a problem of the second trimester, are
History of incompetent cervix
Cervical conization or surgery
Cervical injury
Diethylstilbestrol exposure
Anatomic abnormalities of the cervix
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Differential Diagnosis
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Falling levels of hCG
Complete blood count should be obtained if bleeding is heavy
Rh type should be determined and Rho(D) immune globulin should be given if the type is Rh-negative
All recovered tissue should ...